Association between psychosocial determinants of adverse childhood experiences and severe early childhood caries among First Nations children

Aim To determine whether psychosocial determinants of adverse childhood experiences (ACE), from pregnancy to 2 years old, are associated with severe early childhood caries (S-ECC) in Indigenous children. Design Secondary data analyses from an ECC prevention trial among 344 First Nations mother-child dyads living on- and off-reserve in Ontario and Manitoba, Canada. Stratified (on-/off-reserve) logistic regression, controlling for mother's age and income source, assessed three categories of psychosocial ACE determinants: alcohol/drug misuse, household financial hardship (overcrowding and food insecurity) and emotional/social well-being (Perceived Stress Scale (PSS-14), sense of personal control (SOC), social support, subjective social status). Results Household overcrowding [adjusted odds ratio (AOR) = 1.89 (95% CI: 1.06-3.38)], food insecurity [AOR = 2.86 (1.53-5.34)] and mothers' high perceived stress [AOR = 2.48 (1.40-4.37)] were associated with S-ECC (dmft > 9) for those on-reserve. Maternal SOC had a protective effect for off-reserve children [AOR = 0.17 (0.03-0.95)]. Conclusions Increased efforts to reduce psychosocial ACE determinants are paramount to decreasing Indigenous children's vulnerability to S-ECC.